Feature Story

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Over 700,000 Americans, including twice as many blacks as whites, suffer a stroke each year, and blacks are more likely than whites to die from stroke, according to a recent study that was supported by the Agency for Healthcare Research and Quality (Stroke Prevention Patient Outcomes Research Team, contract 290-91-0028).

The researchers found that elderly blacks on average were 6 percent more likely to die than elderly whites within 3 years after a stroke. This difference was strongest among the youngest elderly; black men aged 65 to 74 were 20 percent more likely than same-aged white men to die within the 3-year period. Black women had similarly lower survival rates in the 65-74 age category, but this disparity disappeared and began to reverse as age increased. However, the researchers caution against attributing these survival differences to biological differences between blacks and whites, since they used only Medicare administrative data that did not provide detailed and reliable clinical information on stroke severity, practice patterns (for example, do-not-resuscitate orders), subsequent disability, lifestyle (for example, smoking), or cultural factors.

For this study, the researchers examined 3-year post-stroke survival rates among white and black elderly patients in the United states, selected from a random 20 percent national sample of elderly Medicare patients hospitalized for stroke in 1991. They identified a total of 47,045 stroke victims, including 5,324 blacks. Compared with whites, black stroke patients had a much higher prevalence of hypertension, diabetes, history of stroke prior to hospitalization, and disability.